Locomotor skill acquisition in virtual reality shows sustained transfer to the real world

• Published in: Journal of neuroengineering and rehabilitation 2019-09, Vol.16 (1), p.113-113, Article 113
• Main Authors: Kim, Aram, Schweighofer, Nicolas, Finley, James M
• Format: Article
• Language: English
• Subjects: Adaptation; Adult; Algorithms; Analysis; Asymmetry; Biomechanical Phenomena; Computer applications; Computer simulation; Feet; Female; Fitness equipment; Foot; Healthy Volunteers; Humans; Influence; Learning; Locomotion; Male; Mobility; Mobility Limitation; Motor ability; Motor learning; Motor skill learning; Motor Skills; Movement disorders; Neurodegenerative diseases; Novels; Obstacle negotiation; Parkinson's disease; Reduction; Retention; Skill learning; Skills; Training; Transfer; Transfer, Psychology; Treadmills; Virtual environments; Virtual Reality; Walking; Young Adult; Young adults
• ISSN: 1743-0003; 1743-0003
• DOI: 10.1186/s12984-019-0584-y

Virtual reality (VR) is a potentially promising tool for enhancing real-world locomotion in individuals with mobility impairment through its ability to provide personalized performance feedback and simulate real-world challenges. However, it is unknown whether novel locomotor skills learned in VR show sustained transfer to the real world. Here, as an initial step towards developing a VR-based clinical intervention, we study how young adults learn and transfer a treadmill-based virtual obstacle negotiation skill to the real world. On Day 1, participants crossed virtual obstacles while walking on a treadmill, with the instruction to minimize foot clearance during obstacle crossing. Gradual changes in performance during training were fit via non-linear mixed effect models. Immediate transfer was measured by foot clearance during physical obstacle crossing while walking over-ground. Retention of the obstacle negotiation skill in VR and retention of over-ground transfer were assessed after 24 h. On Day 1, participants systematically reduced foot clearance throughout practice by an average of 5 cm (SD 4 cm) and transferred 3 cm (SD 1 cm) of this reduction to over-ground walking. The acquired reduction in foot clearance was also retained after 24 h in VR and over-ground. There was only a small, but significant 0.8 cm increase in foot clearance in VR and no significant increase in clearance over-ground on Day 2. Moreover, individual differences in final performance at the end of practice on Day 1 predicted retention both in VR and in the real environment. Overall, our results support the use of VR for locomotor training as skills learned in a virtual environment readily transfer to real-world locomotion. Future work is needed to determine if VR-based locomotor training leads to sustained transfer in clinical populations with mobility impairments, such as individuals with Parkinson's disease and stroke survivors.